California Licensed Compliance Consultant
Job Summary
Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage compliance oversight, conduct coding validation, and perform data-driven analysis to ensure accurate risk capture and regulatory compliance, working remotely within authorized states.
Key responsibilities
- Conduct compliance investigations and audits, analyzing data and identifying potential corrective actions
- Develop compliance reports by evaluating data and summarizing key compliance drivers and performance indicators
- Collaborate with cross-functional teams to implement compliance initiatives and monitor regulatory changes
Required qualifications
- Minimum four (4) years of medical coding experience
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field, along with six (6) years of experience in health care compliance or related areas
- Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Professional Coder
Complete Job Description
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